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RBC Life Insurance CompanyP.O. Box 515, Station AMississauga, Ontario L5A 4M31-800-663-0417 FAX 1-888-246-0098www.rbcinsurance.com RBC Simplified Disability InsuranceRBC Life Insurance Company will pay the benefits provided in this Policy to the Policy Owner. This Policy wasissued to the Policy Owner in consideration of the payment of the premium and the statements made in theapplication.Policy NumberPolicy DatePolicy OwnerInsured en“We”, “Us” and “Our” refer to RBC Life Insurance Company, which We occasionally shorten to RBC Insurance .“You” and “Your” refer to the Policy Owner who is also the insured person.RENEWAL PROVISION.imThis Policy is guaranteed renewable. This means that as long as You pay thepremiums, We cannot cancel the Policy or change its provisions. At Our discretion, We may change futurerenewal premiums, provided We do so for an entire class of policy owners.30 DAY RIGHT TO EXAMINE YOUR POLICY. If You are not satisfied with the Policy You may cancel it byecwriting “Cancel” on it and returning it to Us. If You do so within 30 days after receiving the Policy, We will refundany premium that You have paid, and the Policy will be treated as if it had never been issued.PLEASE READ YOUR POLICY CAREFULLY. It is a legal contract. Your Policy contains all of the informationSpabout your coverage. The definition of the words or phases in the Policy that are in capital letters and can befound in the section entitled “Terms used in this Policy.”RBC LIFE INSURANCE COMPANYRino D'OnofrioPresident and Chief Executive OfficerJohn CarinciVP & Head, Operations & Client ExperienceThis Policy is issued by RBC Life Insurance Company /TMTrademark(s) of Royal Bank of Canada. Used under licence.
Table of ContentsATerms used in this Policy4BWhen Your Policy is in force6CBenefits provided by this Policy7DPaying Your Premiums8ECancelling Your Coverage10FExclusions and Limitations11GInformation about this Policy13HStatutory Conditions1416SpecimenProvincial amendmentsSDI ENG 01.2013Page 3
ATerms used in this policyAccident or Accidental means a sudden and unexpected event arising from an external force of a violent natureover which You had no control.Appropriate Treatment means the form of health care that Physicians with a relevant speciality would generallyconsider effective for a condition causing or contributing to Disability. The Health Care Practitioners who provide thecare must be appropriately trained and licensed to treat the condition. To the extent reasonably possible, thepurpose of the health care must be to enable You to return to work. The health care must be provided under thesupervision of, and with the approval of, a Physician.Class Grouping means an entire group of Policy Owners that share a characteristic or combination ofcharacteristics that We determine to be material to Our risk.Disability and DisabledDisability and Disabled means that due directly to Injury (if You are covered for Injury only) or to Injury or Sickness (ifYou have the Sickness Benefit Rider as indicated on Your Policy Schedule):You are unable to perform the essential duties of Your Regular Occupation(s) (even with any reasonableassistance or modification of job duties);2.You are not working in any Gainful Occupation; and3.You are under the regular care of a Physician and receiving Appropriate Treatment.en1.Drug means any legally controlled substance, alcohol, any fume or inhalant, or any prescription medication,including but not limited to any amphetamine, hallucinogen, opioid, sedative, hypnotic, or anxiolytic.Earnings means all of Your combined Employment Income and Business Income:Employment Income means Your wages, salaries, fees, commissions and some bonuses. A bonus is includedonly if it has been paid by an employer in at least each of the two years before the Starting Date of theDisability, under the terms of a formal bonus program. Employment income does not include: benefits;contributions toward the cost of benefits; or pension or savings plan contributions.2.Business Income means Your share (proportionate to Your ownership interest) of the income or loss, net of allbusiness expenses except income taxes, of any incorporated or unincorporated business in which You have anownership interest (not including corporations whose shares are publicly traded on a stock exchange) and inwhich Your are regularly working.ecim1.SpEarnings does not include unearned income, such as investment income, interest, dividends, capital gains,annuities, trust income, royalties, rental income (except income from the rental of business assets), sick pay orbenefits received under a formal wage continuation plan or disability insurance.Effective Date of Coverage means any of the applicable dates as specified on the Policy Schedule. These are thedates that coverage for each specific benefit begins under this Policy. The Effective Date of Injury may differ fromthe Effective Date of Sickness Coverage.Elimination Period means the number of consecutive days that You must be Disabled following the Starting Dateof the Disability before Monthly Benefits become payable. Monthly Benefits are not payable for during this period.Your Elimination Period is shown on the Policy Schedule.Gainful Occupation means any work for wages or profit that is generating, or could reasonably be expected togenerate Earnings equal to 50% or more of Your Pre-disability Income.Health Care Practitioner means a person who has expertise or training in diagnosing or treating health problemsor symptoms of Sickness or injury. It includes a Physician, psychologist, nurse, chiropractor, physiotherapist,massage therapist, podiatrist, herbalist, naturopath and any other practitioner deemed appropriate by a Physician. Itmay not be You, Your spouse, Your relative or Your business partner.Injury or Injuries means bodily harm or damage that is caused solely and directly by an Accident that occurs afterthe Policy Date and while Your Policy is in force. If the Starting Date of the Disability is more than 120 days after thedate of the Accident We will consider the Disability to be due to Sickness and not to Injury.Intoxicated means the concentration of alcohol in 100 milliliters of Your blood exceeds 80 milligrams (i.e. You havea blood alcohol level of .08). It also means that You have consumed or used a Drug other than in accordance withthe prescription or direction of a Physician.Maximum Benefit Period is the longest period of time that We will pay Monthly Benefits for any one period ofDisability. Your Maximum Benefit Period is shown on the Policy Schedule. A period of Disability may last longerSDI ENG 01.2013Page 4
than the Maximum Benefit Period, but We will not pay Monthly Benefits beyond the Maximum Benefit Period. TheMaximum Benefit Period does not restart and cannot be exceeded during a period of Disability, even if the cause ofDisability changes.Monthly Benefit means the benefit amount that We will pay for each month that a claim based on Disability ispayable. The maximum amount of the Monthly Benefit is shown on the Policy Schedule. The Monthly Benefitamount paid will not exceed 75% of Your Pre-disability Income at the time of a claim. If You are insured under morethan one RBC Simplified Disability Insurance Policy, the combined Monthly Benefits under those policies will notexceed 75% of Your Pre-disability Income at the time of a claim.Monthly Processing Day means the same day of the month as the Policy Date.Physician means a legally qualified and licensed physician, other than You, Your spouse, Your relative or Yourbusiness partner.Policy Anniversary means the same day and month as the Policy Date in each subsequent calendar year that thisPolicy remains in effect.Policy Date means the date from which Policy Anniversaries and your initial premium due is determined. It is thedate the Policy is issued as specified on the Policy Schedule.Premium means the amount You pay Us in consideration for the insurance provided under this Policy. It is specifiedin the Policy Schedule.Pre-disability Income means Your average monthly Earnings in the 24-month period immediately before theenStarting Date of the Disability.Pre-existing Condition means any injury, illness, disease, symptom or heath condition (whether or not the injury,illness, disease, symptom or heath condition is diagnosed, correctly or at all) for which, during the 24 monthsimmediately before the applicable Effective Date of Coverage:You incurred any health-related expenses on the advice of a Physician or any other Health Care Practitioner;b)You took any prescribed medication;c)You consulted a Physician or any other Health Care Practitioner;d)You received any health-related care, advice or treatment, including any diagnostic tests, from a Physician orany other Health Care Practitioner; ore)a reasonably prudent person with such injury, illness, disease, symptom or health condition would haveconsulted a Physician or any other Health Care Practitioner, or would have taken medication previouslyrecommended or prescribed by a Physician.ecima)Regular Occupation means the occupation or occupations in which You were regularly engaged at the StartingSpDate of the Disability. Regular Occupation refers to types of work or vocations rather than to the specific duties ofYour particular job or work at or with a particular business.Sickness means an illness or disease which first manifests itself after the Effective Date of Sickness Coverage andwhile Your Policy is in force.Soft Tissue Injury means any bruise, contusion, tendonitis, whiplash, Strain or Sprain. Strain means the damagethat occurs to muscles from overuse or extreme physical effort. Sprain means damage done to tendons or ligamentsaround a joint and could include slight tears but not a complete break of the tendons or ligaments.Starting Date of the Disability means the first day that You are Disabled at the beginning of a period of Disability.SDI ENG 01.2013Page 5
BWhen Your Policy is in forceB1When Your insurance beginsYour insurance begins on the later of:a)The Policy Date;b)The date Your first monthly Premium is received at Our office. If Your first monthly Premium is not honoured,this Policy will not take effect;If You change your coverage after the initial Policy Date, You will receive a new Policy Schedule. Your newcoverage will begin on the applicable Effective Date of Coverage as shown on that Policy Schedule.B2When Your insurance endsYour insurance ends on the earliest of the following dates:The date of Your death.b)The end of the grace period, if Your Premium is still unpaid as described in D1;c)The Monthly Processing Day following the receipt of Your notice of cancellation, as described in E2;d)The Policy Date, if We contest the validity of the Policy under the terms of G5;e)The Policy Anniversary nearest Your Sixty Fifth (65 ) birthday. It is the Date this Policy expires as specified inthe Policy Schedule.ena)SpecimthSDI ENG 01.2013Page 6
CBenefits provided by this PolicyC1Disability BenefitWe will pay You the Monthly Benefit if You become Disabled. We will not pay You the Monthly Benefit during theElimination Period and We will not pay You the Monthly Benefit beyond the Maximum Benefit Period for any oneperiod of Disability. Payment of the Monthly Benefit Amount is subject to the Limitations and Exclusions of thisPolicy.Please note that this Policy is designed to cover future unexpected events only. As such, this Policy contains anexclusion for any Pre-Existing Injury or Sickness. For details of this exclusion, refer to F4.C2Waiver of PremiumOnce We begin to pay Monthly Benefits to You, We will refund any Premiums that You paid during the EliminationPeriod. We will waive Your Premiums as long as We continue to pay You Monthly Benefits.Recurrent DisabilityenC3C4imIf Your Disability ends before We have paid You benefits for the Maximum Benefit Period, and Your Disability recursfrom the same or related cause within 12 months, We will resume paying You the Monthly Benefit without requiringYou to complete a new Elimination Period. We will consider this to be one period of Disability and Our payments willbe limited to the Maximum Benefit Period.Transplant Donor or Cosmetic Surgery BenefitSpecWe will consider a Disability to be caused by Sickness if it is caused by surgery to donate a part of Your body toanother person, or by cosmetic surgery to improve Your appearance or to correct disfigurement. Such Disability willonly be covered if the surgery takes place at least six months after the Policy Date.SDI ENG 01.2013Page 7
DPaying Your PremiumsD1When Your premiums must be paidEach Premium must be paid on, or before, its premium due date. Premiums must be paid in Canadian dollars.Premiums may be paid annually or monthly. We will allow You to change this by written request, but We will notallow a change while You are Disabled.There is a grace period of 31 days beyond the last premium due date. Your Policy will continue during this graceperiod, but it will automatically lapse (end) if We do not receive payment in full by the end of this grace period.D2Premium refund at DeathUpon notice of Your death, we will make a pro rata refund of any premium paid for a period beyond the month ofYour death.D3Changes in PremiumenIf You have the Sickness Benefit Rider as indicated on the Your Policy Schedule, Your Premium will increase everyfive years. Your future monthly Premium is shown on Your Policy Schedule.D4imAlso, at Our discretion, We may change future Premiums for this plan, provided We do so for an entire class ofpolicy owners. If We decide that a change in Premium is required We will send You a letter with details of thechanges at least sixty (60) days before the new Premium becomes effective.Where and how to make a claimecIf You need to make a claim, You can contact Us at 1-877-519-9501 Monday to Friday 8:00 a.m. to 5 p.m. EST. Ourcustomer service representatives will be happy to help You through the claim process and provide You with thenecessary forms.If You are making or continuing a claim for Monthly Benefits, You will have to provide proof of Your claim by:Fully completing all claim forms that We ask You to complete;b)Providing any information that We determine to be relevant to Your claim (including information about Yourhealth, income and activities);c)Authorizing Us to obtain information from other sources that We determine to be relevant to Your claim(including information from Your present and past Physicians and Health Care Practitioners);d)Being interviewed by one of Our representatives by telephone or in person (if We ask You to); ande)Attending and participating in any examinations or assessments by any Physician or Health Care Practitionerthat We may choose.Spa)During a claim, We may ask You to provide updated proof in one or more of the ways described above. If We do,You must provide the requested proof within thirty (30) days. If it is impossible to provide the requested proof withinthirty (30) days, You must provide it as soon as reasonably possible. If You do not provide the proof that We ask forwithin the time required, We can stop paying You the Monthly Benefit.These requirements for proof of claim will continue even if there has been a breach of the terms of Your Policy.D5Misstatement of AgeIf You understated Your age when You applied for this Policy, We will reduce Your Monthly Benefit to the amountthat the Premiums You paid would have purchased at Your true age.If You understated Your age when You applied for this Policy and We accepted Premiums for a period or periodsbeyond the date Your coverage would have ended based on Your true age, Our liability will be limited to refundingthe Premiums You paid after the date Your coverage would have ended.SDI ENG 01.2013Page 8
If You understated Your age when You applied for this Policy and You would not have been eligible for coverage atYour true age, Our liability will be limited to refunding any Premiums You paid.SpecimenIf You overstated your age when You applied for this Policy, We will refund the amount that You overpaid for theMonthly Benefit that You purchased, and We will provide you with a corrected Policy Schedule showing the revisedInitial Monthly Premium and Future Monthly Premium.SDI ENG 01.2013Page 9
ECancelling Your CoverageE130-Day Policy Review PeriodYou can cancel Your Policy up to thirty (30) days from the date it began with full refund of any Premiums You havepaid. Simply write “Cancel” on this Policy and return it to Us at the following mailing address:RBC InsurancePO Box 515, Station AMississauga, Ontario L5A 4M3Your Policy will be treated as if iI had never been issued.E2Outside the 30-Day Policy Review PeriodYou may cancel Your Policy or any Rider attached to it at any time. Write to Us at the above address or contact Usby phone toll free at 1-800-461-1413 from Monday to Friday, 8:30 a.m. to 5 p.m. EST.enIf Your last Monthly Premium was paid by its due date, We will cancel Your Policy or Rider on the MonthlyProcessing Day following the date We receive Your request to cancel. If Your last Monthly Premium was not paidby its due date and remains outstanding, We will cancel Your Policy or Rider on the date We receive Your writtenrequest to cancel.SpecimIf the Frequency of Premium Payment under Your Policy is annual, the effective date of Your cancellation will be theMonthly Processing Date following the date We receive Your request to cancel, and We will refund the unusedportion of Your Annual Premium.SDI ENG 01.2013Page 10
FExclusions and LimitationsF1Unemployment LimitationthThis limitation applies only if the Starting Date of the Disability occurs before Your 65 birthday.If, on the Starting Date of the Disability, You are unemployed or You are not actually working at least 20 hours perweek on a regular basis, then the word Disability will be deemed to mean the following for the duration of thatDisability:Disability and Disabled means that due directly to Injury or Sickness:a)You are unable to perform the essential duties of any Gainful Occupation for which You have the minimumqualifications;b)You are not working at all; andc)You are under the regular care of a Physician and receiving Appropriate Treatment.This limitation does not apply to scheduled vacations or temporary leaves if You are still considered employed byYour employer.Soft Tissue Injuries and Degenerative Disc Disease LimitationenF2We will pay a cumulative Policy maximum of twenty-four (24) months of Monthly Benefits for any periods of Disabilitythat are caused or contributed to by Soft Tissue Injuries, back Injuries, neck Injuries or degenerative disc disease.F3imThis cumulative maximum will apply even if the periods of Disability are separate from one another.Residency Exclusion and LimitationecWe will not pay Monthly Benefits for any Disability that occurs while You are outside of Canada and the UnitedStates, if the Starting Date of the Disability occurs during the 24 month period immediately following the Policy Date.If You become Disabled after Your Policy has been in force for 24 months, and the Starting Date of the Disabilityoccurs while You are outside of Canada and the United States, You must return to Canada or the United Stateswithin 90 days of the Starting Date of the Disability before You may submit a claim for Monthly Benefits.While You are outside of Canada and the United States:We will not consider You to be Disabled;b)The Elimination Period will not begin or continue; andc)We will not pay Monthly Benefits or waive any premiums.SpF4a)Pre-Existing Condition ExclusionWe will not pay Monthly Benefits nor waive Premiums for any Disability that is caused, directly or indirectly, or is inany manner or degree associated with or occasioned by a Pre-existing Condition.This Pre-existing Condition exclusion will not apply if the Starting Date of the Disability is more than twenty four (24)months after the applicable Effective Date of Coverage.F5Other Exclusions1)We will not pay Monthly Benefits nor waive Premiums for any period of Disability that results, directly orindirectly from, or was in any manner or degree associated with or occasioned by:a)any illness or disease, if You have not purchased Sickness coverage;b)any self-inflicted Injury, whether intentional or unintentional, that occurs while You are Intoxicated;c)Your service in the armed forces, the reserves, or any other military organization;SDI ENG 01.2013Page 11
d)any Injury that occurs while You are using or operating any motorized vehicle while You are Intoxicated;e)Your use of any Drug except as prescribed or directed Your Physician;f)any suicide attempt or other intentionally self-inflicted harm, while sane or insane;g)any opportunistic infection or other illness or disease that Physicians commonly associate with AIDS or theHIV virus;h)any Injury that occurs while You are committing or attempting to commit a crime, whether or not You arecharged with the crime;i)any subjective condition, including but not limited to chronic fatigue syndrome, chronic pain syndrome,fibromyalgia, Epstein Barr syndrome, fibrositis, environmental illness, multiple chemical sensitivity or anyother syndrome or condition characterized predominantly by subjective symptoms; orj)any psychiatric, psychological, emotional, mental or nervous disorder, including but not limited todepression, anxiety, stress, and burnout. This exclusion does not include Disabilities caused by seniledementia or loss of mental capacity resulting from a stroke, head trauma, viral infection or Alzheimer’sDisease.We will not pay Monthly Benefits nor waive Premiums for any period of time You are in a jail, under housearrest, or otherwise incarcerated.3)We will not pay Monthly Benefits nor waive Premiums for any Disability resulting from a normal pregnancy orchildbirth. This exclusion does not apply to Disabilities caused by complications during pregnancy or childbirth.4)We will not pay Monthly Benefits nor waive Premiums for any period of time that You are receiving benefits forloss of earnings under any worker's compensation act or plan.Specimen2)SDI ENG 01.2013Page 12
GInformation about this PolicyG1AssignmentYou may not assign this Policy.G2CurrencyAll monies payable under this contract shall be paid in Canadian dollars, unless otherwise stated.G3Limitation Of ActionsEvery action or proceeding against an insurer for the recovery of insurance money payable under the contract isabsolutely barred unless commenced within the time set out in the Insurance Act or other applicable legislation, orthe time periods set out below, whichever is later.A legal action for Monthly Benefits may not be commenced:b)more than two (2) years after the date the next Monthly Benefit would have become due, if We beganpaying Monthly Benefits and then stopped.Conformity With Provincial Statutesenmore than two (2) years after the date that the first Monthly Benefit became due, if We did not pay anyMonthly Benefits; orimG4a)G5ContestabilityecAny provision of this Policy or any condition of this Policy which, on the Policy Date, is in conflict with the statutes ofthe province in which the policy is delivered, is hereby amended to conform to the minimum requirements of suchprovince.SpIf You made inaccurate statements when You applied for this Policy, We may use these statements to contest thevalidity of Your Policy. After Your Policy has been in force for a period of two years, We will not use thesestatements to contest the validity of Your Policy unless You submit a claim for Monthly Benefits and the StartingDate of the Disability is before the end of that two year period. However, if You made these statements fraudulently,We may use these statements to contest the validity of Your Policy at any time.SDI ENG 01.2013Page 13
HStatutory ConditionsH1The ContractThe application, this Policy, any document attached to this Policy when issued and any amendment to the contractagreed on in writing after this Policy is issued constitute the entire contract, and no agent has authority to changethe contract or waive any of its provisions.H2WaiverThe Company shall be deemed not to have waived any condition of this contract, either in whole or in part, unlessthe waiver is clearly expressed in writing and signed by an officer of the Company.H3Copy of ApplicationH4enThe Company shall upon request furnish to the insured person or to a claimant under this contract a copy of theapplication.Material FactsH5Notice and Proof of ClaimimNo statement made by the insured at the time of application for this contract shall be used in defense of a claimunder or to avoid this contract unless it is contained in the application or any other written statement or answersfurnished as evidence of insurability.H6SpecThe insured or a person insured, or a beneficiary entitled to make a claim, or the agent of any of them, shall (a) givewritten notice of claim to the insurer, ( i) by delivery thereof, or by sending it by registered mail to the head office orchief agency of the insurer in the province; or (ii) by delivery thereof to an authorized agent of the insurer in theprovince, not later than thirty (30) days from the date a claim arises under the contract on account of an accident,sickness or disability, (b) within ninety (90) days from the date a claim arises under the contract on account of anaccident, sickness or disability, furnish to the insurer such proof as is reasonably possible in the circumstances ofthe happening of the accident or the commencement of the sickness or disability, the right of the claimant to receivepayment, and his or her age, and (c) if so required by the insurer, furnish a satisfactory certificate as to the cause ornature of the accident sickness or disability for which the claim may be made under the contract and as to theduration of the disability.Failure to give Notice of ProofFailure to give notice of claim or furnish proof of claim within the time prescribed does not invalidate the claim if thenotice or proof is given or furnished as soon as reasonably possible, and in no event later than twelve (12) monthsfrom the date of the accident, or the date a claim arises under the contract on account of sickness or disability if it isshown that it was not reasonably possible to give notice or furnish proof within the time so prescribed.H7Insurer to furnish forms for proof of claimThe insurer shall furnish forms for proof of claim within fifteen days after receiving notice of claim, but where theclaimant has not received the forms within that time the claimant may submit his or her proof of claim in the form of awritten statement of the cause or nature of the accident, sickness or disability giving rise to the claim and of theextent of the loss.SDI ENG 01.2013Page 14
H8Rights of ExaminationAs a condition precedent to recovery of insurance money under this contract, the claimant shall afford to the insureran opportunity to examine the person of the person insured when and so often as it reasonably requires while theclaim hereunder is pending.H9When loss of time benefits are payableSpecimenThe initial benefits for loss of time shall be paid by the insurer within thirty days after it has received proof of claim,and payment shall be made thereafter in accordance with the terms of the contract but not less frequently than oncein each succeeding sixty (60) days while the insurer remains liable for the payments if the person insured whenrequired to do so furnishes before payment proof of continuing disability.SDI ENG 01.2013Page 15
Provincial amendmentsThis policy contract is amended by adding the following provisions:Limitation of Actions:Every action or proceeding against an insurer for the recovery of insurance money payable under thecontract is absolutely barred unless commenced within the time set out in the Insurance Act (for actionsor proceedings governed by the laws of Alberta and British Columbia), The Insurance Act (for actions orproceedings governed by the laws of Manitoba), the Limitations Act, 2002 (for actions or proceedingsgoverned by the laws of Ontario), or in other applicable legislation in your province of residence. For thoseactions or proceedings governed by the laws of Quebec, the prescriptive period is set out in the QuebecCivil Code.Beneficiary restriction:Your policy contains a provision restricting or removing your right to designate a beneficiary to receive anyinsurance money payable under the contract if,imenthis coverage was purchased over the telephone*;this coverage was purchased on-line*;a Child Term Rider was or will be added to the policy contract;this coverage is a Critical Illness policy which contains a Return of Premium rider;this coverage is a Disability Buy/Sell Insurance policy;this coverage is a Key Person Disability Insurance policy;this coverage is a Retirement Protector Insurance policy; orthis coverage includes a Retirement Protector Rider.Spec*You can designate a beneficiary or beneficiaries of your choice without restriction once your policy has beendelivered to you by completing a Beneficiary Change form.Provincial amendmentsPage 16
This Policy is issued by RBC Life Insurance Company / Trademark(s) of Royal Bank of Canada. Used under licence. RBC Life Insurance Company P.O. Box 515, Station A . Mississauga, Ontario L5A 4M3 1-800-663-0417 FAX 1-888-246-0098 www.rbcinsurance.com RBC Life Insurance Company will pay the benefits provided in this Policy to the Policy Owner.
